Organization
COASTAL ENDONTICS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL S EDDY DMD (MEMBER)
(843) 235-9780
Entity
Organization
Contact information
Practice address
277B WILLBROOK BOULEVARD, PAWLEYS ISLAND, SC 29585-8776
(843) 235-9780
(843) 235-8444
Mailing address
PO BOX 4776, PAWLEYS ISLAND, SC 29585-8776
(843) 235-9780
(843) 235-8444
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
3662
SC
Other
Enumeration date
11/16/2007
Last updated
11/16/2007
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